Provider Demographics
NPI:1538168695
Name:SCHWARTZ, LEE SCOTT (MD)
Entity type:Individual
Prefix:
First Name:LEE
Middle Name:SCOTT
Last Name:SCHWARTZ
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:150 E HURON ST
Mailing Address - Street 2:SUITE 1101
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60611-2999
Mailing Address - Country:US
Mailing Address - Phone:847-256-0576
Mailing Address - Fax:312-642-2934
Practice Address - Street 1:150 E HURON ST
Practice Address - Street 2:SUITE 1101
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60611-2999
Practice Address - Country:US
Practice Address - Phone:847-256-0576
Practice Address - Fax:312-642-2934
Is Sole Proprietor?:Yes
Enumeration Date:2005-07-20
Last Update Date:2015-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL0360607322084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL31600027OtherBCBS
D15248Medicare UPIN
IL31600027OtherBCBS
D15248Medicare UPIN